Cardinali Daniel P, Brusco Luis I, Liberczuk Cynthia, Furio Analía M
Departament of Physiology, Faculty of Medicine, University of Buenos Aires, Argentina.
Neuro Endocrinol Lett. 2002 Apr;23 Suppl 1:20-3.
About 45% of Alzheimer's disease (AD) patients have disruptions in their sleep and sundowning agitation. Since melatonin secretion is greatly inhibited in AD patients we have used melatonin to treat sleep disorders in AD patients since 1995. In a first study [21] we reported, in 7 out of 10 dementia patients treated with melatonin (3 mg p.o. at bed time), a decreased sundowning. In a second study [22] we examined 14 AD patients who received 9 mg melatonin daily for 22 to 35 months, observing a significant improvement of sleep quality with stabilization of behavioral and cognitive parameters. In a third study [23] we reported two monozygotic twins with AD and similar cognitive impairment, one of them receiving 6 mg melatonin at bedtime daily for 3 years. Melatonin treatment improved sleep quality and suppressed sundowning. We now report the effect of melatonin (4-month-long treatment with 6 mg/day) in 45 AD patients with sleep disturbances. Melatonin improved sleep and suppressed sundowning, an effect seen regardless of the concomitant medication employed to treat cognitive or behavioral signs of AD. Melatonin treatment seems to constitute a selection therapy to ameliorate sundowning and to slow evolution of cognitive impairment in AD patients.
约45%的阿尔茨海默病（AD）患者存在睡眠障碍和黄昏时激越症状。由于AD患者的褪黑素分泌受到极大抑制，自1995年以来我们一直使用褪黑素治疗AD患者的睡眠障碍。在第一项研究[21]中，我们报告，10名接受褪黑素治疗（睡前口服3毫克）的痴呆患者中有7名黄昏时激越症状减轻。在第二项研究[22]中，我们检查了14名AD患者，他们每天接受9毫克褪黑素治疗22至35个月，观察到睡眠质量显著改善，行为和认知参数稳定。在第三项研究[23]中，我们报告了一对患有AD且认知障碍相似的同卵双胞胎，其中一人每天睡前服用6毫克褪黑素，持续3年。褪黑素治疗改善了睡眠质量并抑制了黄昏时激越症状。我们现在报告45名有睡眠障碍的AD患者接受褪黑素（每天6毫克，为期4个月的治疗）的效果。褪黑素改善了睡眠并抑制了黄昏时激越症状，无论用于治疗AD认知或行为症状的伴随药物如何，均可见此效果。褪黑素治疗似乎构成一种选择性疗法，可改善AD患者的黄昏时激越症状并减缓认知障碍的进展。
